Prospective Analysis of Arteriovenous Access (AVA) Use in Continuous Renal Replacement Therapy: A Feasibility Project

Other illness

• ESKD patients who, at the time of enrollment, have a sacral pressure ulcer or other clinically significant skin integrity impairment requiring frequent repositioning, extensive patient rotation, or advanced wound care management.

Lab values

• Patients with elevated INR above 5 at the time of study enrollment.
• Patients with acute liver failure, defined as AST \>1000 U/L and/or ALT \>1000 U/L at the time of study enrollment.
• Patients with a platelet count of less than 50,000 (10⁹ plt/L) at the time of study enrollment.

Age

• Age less than 18 years old.

Other

• Patients who receive dialysis via hemodialysis catheter or existing central catheter suitable for hemodialysis.
• Patients with evidence of disseminated intravascular coagulation at the time of study enrollment.
• Known pregnancy at the time of study enrollment.
• Patients at high risk for rapid clinical deterioration, or those deemed unsuitable for AVA-based CRRT by the prescribing nephrologist or ICU physician.

• Age ≥18 years.
• ESKD patients on chronic hemodialysis for \>1 year in duration who are admitted to the ICU and in need of CRRT.
• Anticipated CRRT duration ≥24 hours, based on clinical assessment of the renal trajectory.
• Patient with functioning arteriovenous access, either arteriovenous fistula or arteriovenous graft.
• Expected mechanical ventilation for a minimum of 12 hours, based on clinical assessment of the underlying diagnosis.
• Expected Richmond Agitation Sedation Scale (RASS) goal of 0 or less for a minimum of 12 hours, based on clinical assessment of the underlying diagnosis.
• Patients able to tolerate placement of an arm board at the vascular access site.
• Baseline AVA blood flow of at least 600 mL/min for AVG and 500 mL/min for AVF during ultrasonography evaluation upon enrollment.